| NPI | 1386615391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MI 4301091163) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301091163) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MA 213943) | |
| Enumeration Date | 2006-01-28 |
| Last Update Date | 2019-11-14 |